Steve McCrea wrote: “It sounds like you are defining “mental illness” as any condition that results in people behaving in dangerous or destructive ways. Do you really see these behaviors as “illnesses” in the medical sense?” When I use the term mental illness I do so in the awareness that it is a metaphor. That metaphor in general use encompasses all the unknown diseases, syndromes, damages and congenital malformations to and of the human brain. Unlike others I don’t have an ongoing neurosis about the term mental illness. I see it as a metaphorical holding pen for all that is currently unknown or tentatively understood about the human brain going wrong in some way or other. I think the sensible — although very frightening and unnerving and difficult — probability is that something is physiologically wrong (or to coin the technical term, cock-a-hoop) with someone that goes on a spree killing, yes. There are numerous known physiological causes that can give rise to such wanton violence. We don’t know them all. We may never know them all. And it’s not a routine matter to dissect and closely examine the brains of these murderous lunatics. It should be a routine matter, but it isn’t. On here that physiological cause is often attributed to antidepressants. That’s overstated, but nonetheless a perhaps plausible very minor addition to the very long list of already known possible physiological factors. Everything we do think feel say decide and so on has a physiological factor. I do not much like the majority of human beings, if I get to know them. So the trick is to not get to know them, in order that I can go on liking them, and interacting with them. Deep down, most people operate under that mischief. It takes a narcissism of tremendous achievement to get to the point of holding a gun and deciding on a slaughter of the innocents. To seek out that kind of narcissistic resolution to one’s natural and largely repressed misanthropy takes a tremendously cock-a-hooped brain and central nervous system and gastrointestinal system. To witness such an event is to witness a human machine gone awry. It’s a breakdown event. A malfunction event. To see it any other way, to me, lacks a sense of proportion or basic humanity. People behave like this because something has gone seriously wrong with their bodies, and thus their being. They are, again to coin the technical term, tapped in the head. In that “tapped” process they will often seek out justifying grand narratives, something big and extreme and loathsome and dangerous. Yet often, too, they won’t, and be self-justified by nothing more than I-don’t-like-Mondays. Brains go wrong. The brain is the most complex known organ. It goes wrong in so many ways and in doing so can give rise to breathtaking horrors. A sphincter is a much less complex bodily mechanism. It also goes wrong, and it also can give rise to breathtaking horrors. Why do people here so easily accept that the sphincter goes wrong but struggle so much with the notion of a malfunctioning brain?